Dosimetry is a field of increasing importance in diagnostic radiology. There has been a realization among healthcare professionals that the dose of radiation received by patients via modern medical X-ray examinations could induce acute damage to the skin and eyes. The present study highlights the synthesis of polyvinyl alcohol/nitro blue tetrazolium nanocomposite films (PVA/NBT) for radiation detection depending on chromic, optical, chemical and morphologic changes. First, we synthesized the nanocomposite film-based PVA doped with NBT and the different parameters of the preparation procedure were optimized. Then The films were exposed to different low X-ray doses on the scale of mGy level (0, 2, 4, 10 and 20 mGy). The sensitivity and the performance of the made composite films were evaluated via different characterization methods. Indeed, the response curve based on UV-Vis absorptions revealed a linear increase in absorbance with increased radiation doses (R = 0.998). FTIR analysis showed a clear chemical modification in recorded spectra after irradiation. X-ray diffraction assessment revealed clear structural changes in crystallinity after ionization treatment. SEM analysis showed a clear morphological modification of PVA/NBT films after irradiation. In addition, the prepared PVA/NBT films exhibited excellent pre- and post-irradiation stability in dark and light. Finally, the quantitative colorimetry study confirmed the performance of the prepared films and the different colorimetric coordinates, the total color difference (∆E) and the color strength (K/S) showed a linear increase with increasing X-ray doses. The made nanocomposite PVA/NBT film might offer promising potential for an effective highly sensitive medical dosimeter applied for very low doses in X-ray diagnostic radiology.